Herrmann Wolfgang Artur, Shah Chirag Pradip, von Mohrenfels Christoph Winkler, Gabler Bernhard, Hufendiek Karsten, Lohmann Chris Patrick
University Eye Clinic, University of Regensburg, Franz-Josef-Strauss Allee 11, 93042 Regensburg, Germany.
Graefes Arch Clin Exp Ophthalmol. 2005 Sep;243(9):911-6. doi: 10.1007/s00417-005-1130-0. Epub 2005 Apr 15.
Subepithelial nerves and stromal nerves of the cornea are damaged during LASEK surgery for the correction of myopia. This leads to a reduction in corneal sensation and to alterations of the tear film function in the early postoperative period. The aim of this study was to evaluate tear film function, corneal sensation and subjective symptoms of dry eye in the early postoperative period after LASEK for the correction of myopia.
LASEK surgery was performed in 20 eyes of 10 consecutive patients for the correction of myopia (-1.0 to -9.0 D, mean -4.86 D). Subjective symptoms of a dry eye were evaluated with a standardised questionnaire. Schirmer test with and without local anaesthesia, tear film break-up time, fluorescein staining of the cornea and corneal esthesiometry (Cochet-Bonnet) were performed before surgery and 1 week, 1 month, 2 months and 3 months after LASEK. Additionally corneal staining and subjective symptom severity scores were assessed 3 days after surgery.
Corneal sensation was reduced 1 week after LASEK and recovered during the first month after LASEK. The tear film break-up time was reduced 1 week and 1 month after LASEK and reached preoperative values 2 months after surgery. Fluorescein staining was increased 3 days and 1 week after LASEK. Subjective symptom severity scores were increased 3 days, 1 week, 1 month and 2 months after LASEK. Schirmer tests values with local anaesthesia were significantly reduced at 3 months after surgery, but not at 3 days, 1 month, or 2 months. Schirmer test values without local anaesthesia were significantly decreased 2 and 3 months after LASEK, but not after 3 days and 1 month after LASEK.
LASEK alters ocular surface haemostasis and reduces corneal sensation in the early postoperative period. Subjective symptoms of dry eye were described during the first 2 months after surgery.
在准分子激光上皮下角膜磨镶术（LASEK）治疗近视手术过程中，角膜上皮下神经和基质神经会受到损伤。这会导致角膜感觉减退，并在术后早期引起泪膜功能改变。本研究的目的是评估LASEK治疗近视术后早期的泪膜功能、角膜感觉及干眼主观症状。
对连续10例患者的20只眼进行LASEK手术治疗近视（-1.0至-9.0 D，平均-4.86 D）。采用标准化问卷评估干眼主观症状。在手术前以及LASEK术后1周、1个月、2个月和3个月进行表面麻醉和不进行表面麻醉的泪液分泌试验、泪膜破裂时间、角膜荧光素染色及角膜知觉测量（Cochet-Bonnet）。此外，在术后3天评估角膜染色及主观症状严重程度评分。
LASEK术后1周角膜感觉减退，并在术后第一个月恢复。LASEK术后1周和1个月泪膜破裂时间缩短，术后2个月恢复至术前值。LASEK术后3天和1周角膜荧光素染色增加。LASEK术后3天、1周、1个月和2个月主观症状严重程度评分增加。术后3个月表面麻醉下的泪液分泌试验值显著降低，但术后3天、1个月或2个月时未降低。LASEK术后2个月和3个月不进行表面麻醉的泪液分泌试验值显著降低，但术后3天和1个月时未降低。
LASEK改变眼表稳态，并在术后早期降低角膜感觉。术后前2个月出现干眼主观症状。
